Ma Hongling, Gong Zhaotang, Wu Rihan, SiRi GuLeng
Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China.
Department of Pharmacy, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
Ther Adv Drug Saf. 2024 Sep 23;15:20420986241279128. doi: 10.1177/20420986241279128. eCollection 2024.
Linezolid-induced anemia (LI-AN) is a severe adverse reaction, but risk factors of the LI-AN for elderly patients have not been established.
The objective of this study was to develop a nomogram capable of predicting LI-AN in elderly patients.
This is a retrospective study to develop and validate a nomogram for anemia prediction in elderly patients treated with linezolid.
We retrospectively screened elderly patients treated with linezolid at Inner Mongolia People's Hospital from January 2020 to December 2023 and validated our findings using the MIMIC-IV 2.2 database. Anemia was defined as hemoglobin reduction to 75% of baseline value. Univariate and multivariable logistic regression models were used to identify predictors and construct the nomogram, which was evaluated using receiver operating characteristic (ROC) curve analysis, calibration plot, and decision curve analysis.
A total of 231 patients were enrolled in this study. The training set comprised 151 individuals, and anemia occurred in 28 cases (18.54%). In the external validation set of 80 individuals, 26 (32.5%) were diagnosed with anemia. The predictors included duration of linezolid therapy, patient estimated glomerular filtration rate value, and sequential organ failure assessment score ⩾2. The ROC curve for the training set was 0.830 (95% CI: 0.750-0.910), while a similar ROC curve of 0.743 (95% CI: 0.621-0.865) was obtained for the validation set. The calibration curve demonstrated good correlation between predicted and observed results, indicating that this study effectively predicts risk factors associated with LI-AN in elderly patients.
The developed prediction model can provide valuable guidance for clinicians to prevent anemia and facilitate rational linezolid use in elderly patients.
利奈唑胺诱导的贫血（LI-AN）是一种严重的不良反应，但老年患者发生LI-AN的危险因素尚未明确。
本研究旨在开发一种能够预测老年患者LI-AN的列线图。
这是一项回顾性研究，旨在开发并验证用于预测接受利奈唑胺治疗的老年患者贫血情况的列线图。
我们回顾性筛选了2020年1月至2023年12月在内蒙古自治区人民医院接受利奈唑胺治疗的老年患者，并使用MIMIC-IV 2.2数据库验证我们的研究结果。贫血定义为血红蛋白降至基线值的75%。采用单因素和多因素逻辑回归模型确定预测因素并构建列线图，通过受试者工作特征（ROC）曲线分析、校准图和决策曲线分析对其进行评估。
本研究共纳入231例患者。训练集包括151例个体，其中28例（18.54%）发生贫血。在80例个体的外部验证集中，26例（32.5%）被诊断为贫血。预测因素包括利奈唑胺治疗时长、患者估计肾小球滤过率值以及序贯器官衰竭评估评分≥2。训练集的ROC曲线为0.830（95%CI：0.750-0.910），而验证集的ROC曲线与之相似，为0.743（95%CI：0.621-0.865）。校准曲线显示预测结果与观察结果之间具有良好的相关性，表明本研究有效地预测了老年患者中与LI-AN相关的危险因素。
所开发的预测模型可为临床医生预防贫血提供有价值的指导，并有助于老年患者合理使用利奈唑胺。
